15May 2017

TIBIALHEMIMELIA; DO WE NEED A MODIFICATION OF THE CURRENTLY USED CLASSIFICATION SYSTEMS?

  • Assistant lecturer of Pediatric Orthopedic Surgery, Faculty of Medicine, Sohag University, Egypt.
  • Lecturer of Pediatric Orthopedic Surgery, Faculty of Medicine, Sohag University, Egypt.
  • Lecturerof Orthopedic Surgery, Faculty of Medicine, Sohag University, Egypt.
  • Abstract
  • Keywords
  • References
  • Cite This Article as
  • Corresponding Author

Background: Tibialhemimelia is a rare congenital anomaly,it may occur in isolated form or combined with other congenital anomalies.Differentclassification systemshad been used for classification. While inferior tibiofibular joint diastasis is a well-known accompanying deformity in subtypes of different classification systems; complete diastasis of tibia and fibula is not included in either of classification systems. Methods:Case 1: A 15 days infant presented to our unit with complete diastasis of tibia and fibula from the level of the knee joint. Each bone has its own skin envelop. Case 2:A four weeks old boy with a partial distal diastasis of tibia and fibula from the level of mid leg downward, with almost completely separate skin envelop for each part of the bone. A search in the English literature about reported cases with complete diastasis of tibia and fibula and different classification systems for tibialhemimelia was done. Result: No reported cases in the literature with complete diastasis of tibia and fibula. Conclusion: We suggest modification of the current classification systems for tibialhemimelia to include complete diastasis of tibia and fibula as a variant. Level of evidence: Level IV


  1. Brown FW. The brown operation for total hemimeliatibia.In: Aitken GT (ed) Selected lower-limb anomalies. National Academy of Sciences, 1971; Washington pp 20?28.
  2. Weber M, Schro?der S, Berdel P, Niethard FU. Register zurbundesweitenErfassungangeborenerGliedma?enfehlbildungen. Z Orthop.2005; 143:1?5.
  3. Billroth T. UebereinigedurchKnochendefectebedingteKru?mmungen des Fusses. Arch Klin Chir.1861; 1:252?268
  4. Dankmeijer J. Congenital absence of the tibia.Anat Rec.1935;62:179?194
  5. Mirzatolooe. Tibialhemimelia with separate soft-tissue cover of the tibia and fibula,J Bone Joint Surg Br.2011 Jul;93(7):990-1000.
  6. Jones D, Barnes J, Lloyd-Roberts GC.?Congenital aplasia and dysplasia of the tibia with intact fibula: classification and management.?J Bone Joint Surg [Br]1978;60-B:31?9.
  7. Kalamchi A,?DaweRV.Congenitaldeficiency?of the?tibia.J Bone Joint Surg Br.?1985;67(4):581-4.
  8. Weber M.?New classification and score for tibialhemimelia.?J Child Orthop.2008; 2:169?75.
  9. Bose K. Congenital diastasis of the inferior tibiofibular joint. J Bone JointSurg [Am].1976;58:886?887.
  10. Fernandez-Palazzi F, Bendahan J, Rivas S. Congenital deficiency of thetibia: A report on 22 cases. J PediatrOrthop.1998;7:298?302.
  11. Tuli SM, Varma BP. Congenital diastasis of the tibio-fibular mortise. JBone Joint Surg [Br].1972;54:346?350.
  12. Kantaputra PN, Chalidapong P.?Are triphalangeal thumb-polysyndactyly syndrome (TPTPS) and tibialhemimelia-polysyndactyly-triphalangeal thumb syndrome (THPTTS) identical? : a father with TPTPS and his daughter with THPTTS in a Thai family.?Am J Med Genet.2000;93:126?31.
  13. Stevens CA, Moore CA.?Tibialhemimelia in Langer-Giedion syndrome: possible gene location for tibialhemimelia at 8q.?Am J Med Genet.1999; 85:409?12.

[Abdelaal. Ahmed Hamed Kassem, Morsy. Ahmad Fawaz. Ashraf RashadMarzouk. and Ahmed Sleem. (2017); TIBIALHEMIMELIA; DO WE NEED A MODIFICATION OF THE CURRENTLY USED CLASSIFICATION SYSTEMS? Int. J. of Adv. Res. 5 (May). 281-284] (ISSN 2320-5407). www.journalijar.com


Abdelaal Ahmed Hamed Kassem
Assistant lecturer of Pediatric Orthopedic Surgery, Faculty of Medicine, Sohag University, Egypt.

DOI:


Article DOI: 10.21474/IJAR01/4108      
DOI URL: https://dx.doi.org/10.21474/IJAR01/4108